1. Vital Signs 101Vital Signs 101

2. Blood pressureBlood pressure
 Blood pressure is the measure of theBlood pressure is the measure of the
stretch inside the walls of the vesselsstretch inside the walls of the vessels
 Remember about putting your finger overRemember about putting your finger over
the hose- what happens to the waterthe hose- what happens to the water
pressure?pressure?
 What happens to the hose?What happens to the hose?

3. Blood pressureBlood pressure
 What we eat cheese burgers, drink sugaryWhat we eat cheese burgers, drink sugary
sodas, and pizza regularly, fat forms in thesodas, and pizza regularly, fat forms in the
arteries, and vessels called plaque.arteries, and vessels called plaque.
 The plaque calcifies and becomes hard andThe plaque calcifies and becomes hard and
makes the vessel narrow the lumen, or themakes the vessel narrow the lumen, or the
passage way for blood.passage way for blood.
 If we eat high fiber, and low fat, we do not buildIf we eat high fiber, and low fat, we do not build
plaqueplaque

4. blood pressureblood pressure
 Blood pressure is made up of 2 numbersBlood pressure is made up of 2 numbers
 1. systolic= the squish or contraction of1. systolic= the squish or contraction of
the heartthe heart
 2. diastolic= the relax of the heart2. diastolic= the relax of the heart
 If the heart has to work hard to squishIf the heart has to work hard to squish
because the pressure in the vessels isbecause the pressure in the vessels is
blocking blood flow, then the heartblocking blood flow, then the heart
cannot relax as well between beatscannot relax as well between beats

5. Blood pressureBlood pressure
 The equipment you will need to gather toThe equipment you will need to gather to
take a blood pressure will be:take a blood pressure will be:
 1. a stethoscope1. a stethoscope
 2. a sphygmomanometer (blood pressure2. a sphygmomanometer (blood pressure
cuff) sphyg--Greek blood/throbcuff) sphyg--Greek blood/throb

6. Blood pressureBlood pressure
 Wait a minute! considerations!Wait a minute! considerations!
 to avoid faulty measurements---to avoid faulty measurements---
 BP higher if exercise, smoking or ‘cokes’ before the BP check.BP higher if exercise, smoking or ‘cokes’ before the BP check.
 No BP check if arm bruising/wound/swelling abnormality or kidneyNo BP check if arm bruising/wound/swelling abnormality or kidney
dialysis or breast surgery.dialysis or breast surgery.
 Step one- always wash your handsStep one- always wash your hands
 Step two- introduce yourself, and explain the procedureStep two- introduce yourself, and explain the procedure
 Step three- visualize the arrow on the cuff, and aim the arrow atStep three- visualize the arrow on the cuff, and aim the arrow at
the brachial artery after you palpate the pulse at the brachial sitethe brachial artery after you palpate the pulse at the brachial site
 Step four tighten the cuff approx 2 inches above anticubital areaStep four tighten the cuff approx 2 inches above anticubital area
and be able to place 2 fingers inside the cuffand be able to place 2 fingers inside the cuff
 Step five, place your stethoscope diaphragm over the brachialStep five, place your stethoscope diaphragm over the brachial
pulse areapulse area

7. Blood pressureBlood pressure
 Step 6 position the dial where you can see itStep 6 position the dial where you can see it
 Step 7 clamp the air valve on the pump, andStep 7 clamp the air valve on the pump, and
begin pumping air in to the cuff until you reachbegin pumping air in to the cuff until you reach
180 on the dial- note you can go higher if180 on the dial- note you can go higher if
patient has a history of HTNpatient has a history of HTN
 Step 8- slowly release the valve until you hearStep 8- slowly release the valve until you hear
the first audible sound. Note, the dial may startthe first audible sound. Note, the dial may start
ticking, but do not count the systolic numberticking, but do not count the systolic number
until you hear the sounduntil you hear the sound

8. Blood pressureBlood pressure
 Step 9- note the top or systolic numberStep 9- note the top or systolic number
and continue to release the air valve untiland continue to release the air valve until
the sound either drops to a quiet distantthe sound either drops to a quiet distant
sound or stops abruptly. This will be thesound or stops abruptly. This will be the
diastolic numberdiastolic number
 Step 10 record your findings.Step 10 record your findings.

9. Blood pressureBlood pressure
 Remember, you are a student, and doRemember, you are a student, and do
not have authority to diagnose. If anot have authority to diagnose. If a
patient asks you about your findings, youpatient asks you about your findings, you
will refer them to their physician, Dr.will refer them to their physician, Dr.
Pate, Nurse Hoffman or Nurse Browlee.Pate, Nurse Hoffman or Nurse Browlee.
 Thanks for your attention we are happyThanks for your attention we are happy
to serve….to serve….

10. TemperatureTemperature
 normal is 98.6F (97.8-99F)normal is 98.6F (97.8-99F)
 why fever?(pyrexia) body assumes bacterial infection and rasies temp to ‘fry’bateriawhy fever?(pyrexia) body assumes bacterial infection and rasies temp to ‘fry’bateria
 when to worry? hit 104Fwhen to worry? hit 104F
 orallyTemperature can be taken by mouth using either the classic glassorallyTemperature can be taken by mouth using either the classic glass
thermometer, or the more modern digital thermometers that use an electronicthermometer, or the more modern digital thermometers that use an electronic
probe to measure body temperature.probe to measure body temperature.
 rectallyTemperatures taken rectally (using a glass or digital thermometer) tend torectallyTemperatures taken rectally (using a glass or digital thermometer) tend to
be 0.5 to 0.7be 0.5 to 0.7 ｰｰ F higher than when taken by mouth.F higher than when taken by mouth.
 axillaryTemperatures can be taken under the arm using a glass or digitalaxillaryTemperatures can be taken under the arm using a glass or digital
thermometer. Temperatures taken by this route tend to be 0.3 to 0.4thermometer. Temperatures taken by this route tend to be 0.3 to 0.4 ｰｰ F lowerF lower
than those temperatures taken by mouth.than those temperatures taken by mouth.
 by ear(tympanic)A special thermometer can quickly measure the temperature ofby ear(tympanic)A special thermometer can quickly measure the temperature of
the ear drum, which reflects the body's core temperature (the temperature of thethe ear drum, which reflects the body's core temperature (the temperature of the
internal organs).internal organs).
 by skinA special thermometer can quickly measure the temperature of the skin onby skinA special thermometer can quickly measure the temperature of the skin on
the forehead.the forehead.